Abstract
We describe a case of a 37-year-old woman with generalized pustular psoriasis (GPP) that worsened rapidly postpartum. A diagnosis of GPP was made when she was 3months old. She had been treated with topical corticosteroid and oral administration of cyclosporine. After the delivery of a second baby, she developed a severe rash and her general status worsened markedly. Although the dosage of cyclosporine was increased to 250 mg/day in addition to oral prednisolone (20 mg/day → 50 mg/day), the response was poor. Therefore, we started treatment with infliximab, resulting in an excellent response within 6 days. As far as we know, there has been no previous report of GPP worsening postpartum in Japan. With regard to the use of cyclosporine and infliximab during pregnancy or lactation, it is one of the options for the treatment of severe cases, according to the guidelines. However, the use of these drugs have to be considered carefully while comparing the risks and benefits.
